Individual
MIRANDA E JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
117 W 5TH ST STE 100, BARTLESVILLE, OK 74003-6615
(918) 203-3313
Mailing address
117 W 5TH ST STE 100, BARTLESVILLE, OK 74003-6615
(918) 203-3313
(918) 512-4082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2454
OK
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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